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BLOOD & BLOOD PRODUCTS. BLOOD Whole Blood Packed Cell Granulocytes. BLOOD PRODUCTS F.F.P. Cryoprecipitate Platelete. Blood Components Preparation. Based on different specific gravities RBC : 1.08-1.09 Platelet : 1.03-1.04
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BLOOD Whole Blood Packed Cell Granulocytes BLOOD PRODUCTS F.F.P. Cryoprecipitate Platelete
Blood Components Preparation • Based on different specific gravities • RBC : 1.08-1.09 • Platelet : 1.03-1.04 • By using differential centrifugation,blood components separated into layers
From a unit of whole blood,the centrifuged product settle out into RBC,WBC & platelet-rich plasma(PRP). • After separating PRP fr the bag,PRP again being centrifuge for a longer time & harder spin. • Plt is heavier than plasma & will settled at the bottom of the bag.
WHOLE BLOOD • Source of product for all blood components • 400-500 ml • Storage temperature :1-6 C • Ind.:to maintain blood volume & O2 carrying capacity in acute,massive blood loss. • Actively bleeding pt>20% of body blood volume.
PACKED CELL • Prepared by removing 200-250ml of plasma from a unit of W.B. • 200-250 ml • Do not contain functional platelets or granulocytes • Have the same O2 carrying capacity with W.B • Ind.:to increase the O2 carrying capacity in anaemic pt who require an increase in their red cell mass w/out increase in their blood volume. • 1 unit: increase Hb level about 1g/dL (10g/L)& Hct by 3%.
GRANULOCYTES • Prepared by leukoparesis tech. • Contain of • Large number of granulocytes • Other leucocytes • 20-50ml of RBC • Ind.: • Supportive tx for pt with severe neutropenia with documented sepsis unresponsive to a/biotic tx. • Neonatal sepsis.
PLATELET • Prepared by cytapheresis/by seperating PRP fr a unit of W.B w/in 8H of collection & recentrifuge to remove plasma. • Stored at 20-24C. • Each unit of plt expected to increase 5000-10000 plt.
Indications: • Prophylaxis. • Dilutional thrombocytopenia • Active bleeding d/t thrombocytopenia/thrombocytopathy.
FRESH FROZEN PLASMA • Prepared by removing plasma fr W.B w/in 8H of collection. • Stored at –18C or below. • Contains of: • Water,carbohydrates,fats,minerals • Proteins(all labile & stable clotting fx). • 200-225ml • Each unit of FFP=increase the level of each clotting fx by 2-3% in adults. • Therapeutic dose : 10-15ml/kg.
Indications: • As a replacement for isolated coagulation fx def. • The reversal of warfarin Tx. • In the case of massive blood transfusion. • Antithrombin III def.Tx. • Correction of coagulopathy a/w liver disease. • Thrombotic thrombocytopenic purpura.
CRYOPRECIPITATE • The cold-insoluble portion of plasma that remains after FFP has been thawed at 1-6C. • Contains of: • Factor VIII:C • Factor VIII:vWF • Factor XIII • Fibrinogen • About 10-15ml of plasma • Stored at –18C & below.
Indications: • von Willebrand’s disease • Hemophillia A • Factor XIII def. • Cong./acquired fibrinogen def.
ACUTE IMMUNOLOGIC EFFECTS 1}Hemolytic transfusion reactions • Mediators:IgM A/b (usuallyABO), complement. • Sx/sn:fever,chill,hemoglobinemia, hemoglobinuria,hypotension,dyspnea. • Mx/px:decrease opportunities for error,treat ARF & DIC.
2}Nonhemolytic febrile transfusion reactions • Mediators:A/b to HLA Class I Ag. • Sx/sn:fever,chill. • Mx/px:antipyretics,leukocyte depletion.
3}Allergic transfusion reactions. • Mediators:plasma proteins(mild reactions), A/b to IgA(anaphylactic reactions). • Sx/sn:urticaria,erythema,itching, anaphylaxis. • Mx/px:antihistamines;treat sx,transfuse IgA-deficient components.
4}Noncardiogenic pulmonary transfusion reactions • Mediators:donor/recipient WBC A/b. • Sx/sn:ARD,fever,chill,cyanosis,hypotension ,noncardiogenic pulmonary edema. • Mx/px: vigorous respiratory support, steroids.
ACUTE NONIMMUNOLOGIC EFFECTS 1}Bacterial contamination • Md :endotoxins produced by GN bact. • Sx/sn:fever,shock,hemoglobinuria. • Mx/px:IV a/biotics;treat hypotension & DIC.
2}Circulatory overload • Md: fluid volume. • Sx/sn:coughing,cyanosis,orthopnea,severe headache,peripheral edema,diff breathing. • Mx/px:administer subsequent Tx slowly & in a small volume.
3}Hemolysis d/t physical/chemical means • Md:exogenous destruction of RBC. • Sx/sn:hemoglobinuria. • Mx/px:document & rule out hemolysis d/t other causes;treat DIC.
DELAYED IMMUNOLOGIC EFFECTS 1}Hemolytic transfusion reactions. • Md:IgG A/b. • Sx/sn:shortened RBC survival,decreased Hb,fever,jaundice,hemoglobinuria. • Mx/px:Ag-negative blood for further transfusions.
2}Transfusion associated Graft-versus-host disease • Md:viable donor lymphocytes. • Sx/sn:fever,skin rash,desquamation,anorexia,nausea, vomiting,diarrhea,hepatitis,pancytopenia • Mx/px:gamma irradiation of cellular components.
3}Post-transfusion purpura • Md:platelet specific A/b. • Sx/sn:thrombocytopenia,clinical bleeding. • Mx/px:IV Ig,plasma exchange, corticosteroids.
DELAYED NONIMMUNOLOGIC EFFECTS Transfusion-Induced Hemosiderosis. • Md:Iron overload. • Sx/sn: subclinical to death. • Mx/px:decrease fq of transfusion,neocytes, iron chelation therapy.
STEPS TO BE FOLLOWED • Discontinue the transfusion. • Keep the IV line open with N/saline. • Check all labels,forms & pt identification. • Report to Blood Bank personnel. • Send requested blood samples.
